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Wednesday, 1 May 2013

Nasogastric Tube

Definition:
It is a medical procedure that performed by a tube that enter from nose to throat to esophagus to end stomach.

Uses of Nasogastric Tube:
Its use for the feeding.
Administration of medication.
For other agents like; activated Charcoal.
Nasogastric aspiration (gastric lavage).
To empty the stomach from poisoning substances or other secretions, bag attached and maintain below the patients position gravity helps to empty the stomach.
To prevent the aspiration of stomach contents.

How to Inserted?
Before the insertion take the size from patient, from the tip of the nose to ear loop, then down toward the xiphoid sternum to roughly below 5 cm.
Use the local anesthesia ( 2% Xylocaine gel) before insertion, at the end tip of tube.
Enter the tube in this pathway; Nose __Throat__Esophagus__Stomach.
Size Varies: 12-14 Gauge in Green Color, 16-18 Gauge in Red Color.
There are four marking on NG tube;
1st at 18" (46 cm)
2nd at 22" (56 cm)
3rd at 26" (66 cm)
4th at 30" (76 cm)
When you enter the tube from mouth to stomach patient may awake or show gag reflexes.
Say patient to mimic like swallowing, give him/her water to sip with straw.
And during this procedure enter the tube in stomach.

Caution:
NG tube must be inserted by an experienced person.
Avoid to enter the NG tube into the trachea.

Confirmation:

It can confirm by Air syringe to enter air in stomach it will be distended.

Aspirate the stomach content check its pH by litmus paper; it should be 5.5 or below acidic.

You can perform an x-ray.

Contraindications:
Its is contraindicated in Skull fractures (Basal), Severe facial fracture, Obstruction on esophagus and nose too and in gastric bypass surgery.

Complications:

Its can cause nose bleeding.

Sinusitis.

Its lead to sore throat and swelling in nose.

Perforation of esophagus.

Aspiration of Lungs.

Lungs Collapsed.

If not propered sized it can go in duodenum (confirmed by gastric enzymes).